Young children are far more likely to experience attention and hyperactivity problems if their mother develops diabetes during pregnancy and they are born into a poor or lower-middle-class household , a new study suggests .

The study , published this week in the Archives of Pediatrics and Adolescent Medicine , found that children whose mothers received a diabetes diagnosis during pregnancy -LRB- known as gestational diabetes -RRB- were twice as likely as their peers to meet the criteria for attention deficit hyperactivity disorder -LRB- ADHD -RRB- at age six .

Living in a family with below-average socioeconomic status likewise doubled the risk of ADHD in six-year-olds . But children with both risk factors -- those who were exposed to gestational diabetes and grew up in a less-than-affluent household -- had a 14-fold increased risk of ADHD compared to children with neither risk factor .

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The findings do n't prove that gestational diabetes directly causes ADHD , but the researchers say they send a message to mothers and doctors that gestational diabetes may pose hidden dangers to a child well after birth , especially if the child grows up in a challenging environment .

`` Mothers should be aware that gestational diabetes can affect her fetus , '' says Yoko Nomura , Ph.D. , the lead author of the study and an assistant clinical professor of psychiatry at the Mount Sinai School of Medicine , in New York City .

Gestational diabetes , which affects roughly 5 % of expectant mothers in the United States , generally develops during the second or third trimester of pregnancy -- the same window of time in which a fetus undergoes a critical burst of brain development .

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Women with gestational diabetes have abnormally high blood sugar -LRB- glucose -RRB- . If the fetus is bombarded with excess blood sugar , energy normally used for nervous-system development could potentially be diverted to absorb that excess , Nomura says . As a result , the central nervous system may not develop properly .

Growing up in poverty would likely aggravate any underlying nervous-system deficits , Nomura says .

`` When babies are born into higher socioeconomic status households , they have better access to medical care -LSB- and -RSB- remedial activities , intellectual stimulus is higher , they have better foods , '' she says .

In addition , low-income women may not control their gestational diabetes as well as more prosperous mothers-to-be , says Luigi Garibaldi , M.D. , clinical director of pediatric endocrinology at the Children 's Hospital of Pittsburgh .

`` Having diabetes during pregnancy by itself may not be so bad , but if you do n't take care of it , there may be consequences on the brain development of the child , '' says Garibaldi , who was not involved in the study .

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Nomura and her colleagues followed 212 ethnically and socioeconomically diverse children living in Queens , New York , 10 % of whom were exposed to gestational diabetes . From preschool through age six , a trained psychologist or doctoral student evaluated each child for ADHD symptoms annually .

The study had several shortcomings . It was relatively small , and although they did take into account the parents ' history of ADHD , the researchers did n't collect data on whether the children had siblings or other relatives with attention or hyperactivity problems . Also , Garibaldi notes , the researchers did n't measure how well the mothers controlled their gestational diabetes .

Still , the study is a valuable reminder that a child 's environment -- in and out of the womb -- appears to affect the risk of ADHD , says Joel Nigg , Ph.D. , a professor of psychiatry at Oregon Health & Science University , in Portland .

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Previous research suggests , for instance , that children are at increased risk of ADHD if they 're exposed to lead and certain pesticides .

`` As a precaution , we might want to add -LSB- gestational diabetes -RSB- to the list of risk factors we 're aware of , '' says Nigg , who wrote an editorial accompanying the study .

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Findings do n't prove that gestational diabetes directly causes ADHD

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Mothers should be aware that gestational diabetes can affect a fetus , author says

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Growing up in poverty likely aggravates any underlying nervous-system deficits